Burden of premature ventricular contractions beyond nonsustained ventricular tachycardia is related to the myocardial extracellular space expansion in patients with hypertrophic-cardiomyopathy

Hyemoon Chung, Chul Hwan Park, Yoonjung Kim, Jong Youn Kim, Pil Ki Min, Young Won Yoon, Kyung A. Lee, Byoung Kwon Lee, Bum Kee Hong, Tae Hoon Kim, Se Joong Rim, Hyuck Moon Kwon, Eui Young Choi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Although nonsustained ventricular tachycardia (NSVT) is a risk factor for sudden cardiac death in hypertrophic-cardiomyopathy (HCM), the impact of premature ventricular contraction (PVC) burden, in the absence of NSVT, is not well-known. Hypothesis: PVC burden may be associated with myocardial fibrosis and genetic mutations in patients with HCM. Methods: Of the 212 patients prospectively enrolled to the HCM registry of genetics, 84 were evaluated with both cardiac magnetic resonance, 24-hour Holter monitoring and genetic analysis. Among them, 71 patients have not been diagnosed with NSVT. Results: Patients with NSVT (n = 13) had a higher late gadolinium enhancement (LGE) amount, extracellular volume fraction (ECV), and prevalence of sarcomere mutations compared with patients without NSVT. Among patients without NSVT, those with LGE (n = 46) had a higher total PVC (109 ± 332 vs 7 ± 13, P =.003) and PVC burden (0.114 ± 0.225 vs 0.008 ± 0.014%, P =.003) during 24-hour Holter monitoring compared with others. The %LGE and global ECV were correlated with PVC burden (r = 0.377, P =.001; r = 0.401, P =.001). The optimal cutoff value for PVC number for LGE was 45 (37.0% and 100% sensitivity and specificity, respectively) with 0.733 of the area under the receiver operating characteristic-curve (P <.001). Thick filament gene mutation was more prevalent in the higher PVC burden group (41.2% vs 16.7%, P =.048). Conclusion: Total PVC burden is significantly related to increase in myocardial fibrosis in HCM patients without NSVT.

Original languageEnglish
Pages (from-to)1317-1325
Number of pages9
JournalClinical Cardiology
Volume43
Issue number11
DOIs
Publication statusPublished - 2020 Nov

Bibliographical note

Funding Information:
This work was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education. (2014R1A1A2055872).

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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